Using Lay Health Advisors to Improve Hypertension Management

Using Lay Health Advisors to Help African Americans Address the Social Context of Hypertension Management

Hypertension disproportionately affects and is inadequately controlled among African American and poor populations. The investigators propose to determine the impact of using trained lay health advisors to help patients address social contextual factors that influence the management of hypertension.

Hypertension disproportionately affects and is inadequately controlled among African American and poor populations. Health providers generally lack the skills and resources to address social contextual factors (i.e. health and community services, social networks, social stressors, physical environment, and economic resources) that influence management of hypertension. Instead, providers tend to focus on adjusting antihypertensive medication prescriptions and exhorting patients to exercise and eat better. The investigators propose to determine the impact of using trained lay health advisors to help patients address social contextual factors that influence the management of hypertension. Helping patients address these barriers may lead not only to improved blood pressure but also to increased survival, reduced organ damage, and decreased health care costs. This project may also serve as a model of healthcare delivery innovation that could be used to address other health disparity conditions.

Patients will meet regularly Lay Health Advisors who will address the social context of their hypertension.

Differences in quality of life between final and initial measurements using the 12 item short form survey (SF-12). The SF-12 provides physical and mental health composite scores ranging from 0 (lowest level of health) to 100 (highest level of health)

Inclusion Criteria: At least 2 outpatient blood pressures with systolic >140 or diastolic >90 mm Hg in last 6 months. Separate occurrences at least 1 day apart Age 18-59 years Non-diabetic Preserved kidney function (glomerular filtration rate >60 ml/min) English speaking Exclusion Criteria: Mentally incompetent Pregnant Terminal illness Active substance abuse Documented coronary, peripheral arterial, or cerebrovascular disease

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